Distance Surgery Program
*If you would like to participate in our distance program, please
advise us several weeks in advance of your arrival, preferably when you first contact us.
It is essential that we reserve slots for the operating room and medical imaging facilities
to make your experience as smooth as possible.
The UCLA Endocrine Surgery Distance Program was created to meet the demands of our increasing
patient population living outside of the Los Angeles metropolitan area.
In order
to be eligible, patients must live more than 2 hours’ drive away (without traffic)
from UCLA and be in good general health.
The program’s strategy involves maximum utilization of suitable medical services
in the participant’s local area, followed by a concentrated period of specialty services
(imaging, consultations, pre-operative evaluation, and surgery) performed at UCLA spanning
one week or less. Effective communication between our office, the patient, and referring
physician is essential.
Our goal is to minimize out-of-pocket medical expenses, travel
time, and overall impact on the patient’s schedule.
Most US patients who have traveled to UCLA for surgery from outside of Southern California/Nevada
area did so because they have close relatives living in Los Angeles. See A
word about traveling for surgery below.
If you live near a major University medical center,
it is likely that an endocrine surgery specialist can be found there.
Thorough
preparatory work is required to ensure a smooth experience. Patient initiative is required
for steps shaded yellow.
 After initial contact, our office will provide a brief checklist outlining the records
and tests results necessary to establish the diagnosis. All biopsy specimens are routinely
reviewed by a UCLA endocrine pathologist.
For patients with chronic diseases such as high blood pressure or diabetes, an evaluation
by their primary care physician within the past 1 year is necessary. For patients with a
history of heart disease, we require evaluation by a cardiologist within the past 6 months.
Certain imaging studies, most notably ultrasound and parathyroid sestamibi (a nuclear
medicine test), are subject to operator variability (1, 2).
In other words, studies performed
by experienced personnel are significantly more sensitive than those performed at low-volume
centers.
For patients that have not yet had imaging studies, we recommend that they wait to undergo
ultrasound and nuclear medicine imaging here at UCLA.
Though we will utilize positive outside
results, patients with negative outside results should expect to undergo repeat imaging at
UCLA.
Download/Print Protocol Flow
Chart 
A typical itinerary for a weeklong visit is shown below. Though the schedule is full,
it is reasonably paced and well-coordinated. To date, no patients have found it unduly stressful.
Some patients may require hospitalization beyond 1 night depending on their condition.
Download/Print Sample Schedule
A list of nearby hotels, some of which offer discounted rates and/or free transportation
to UCLA Medical Center, can be found at:
http://www.uclahealth.org/body.cfm?id=116&oTopId=42
http://www.uclahealth.org/body.cfm?id=121&oTopId=42
Traveling for surgery is sometimes necessary if you have an unusual condition
that requires specialized medical care. Most endocrine operations do fall into this
category, as high-volume centers are known to have improved patient outcomes compared
to non-specialty centers for thyroid, parathyroid, and adrenal surgery (More on Outcomes
in endocrine Surgery).
That said, we strongly feel that patients should have surgery while staying near
family and other social supports whenever possible. In other words, stay close to
home if you can. Though minimally invasive techniques have shortened recovery time
from surgery by a large margin, surgery (even "minor" surgery) remains
a physically and emotionally stressful event. Thus, it goes without saying that patients
benefit from being near family and friends.
Specialized endocrine surgery centers exist in most major U.S. cities and tend
to be clustered around universities (See Overview of Endocrine Surgery). Most people
in the U.S. should not have to travel more than a few hundred miles to reach one
of these centers. To find an endocrine surgery center near you, please see our listing
of affiliated centers. Or please feel free to contact us by phone or email - we will
be happy to help you find the resources that you seek.
Follow up is performed remotely. Two weeks after surgery, patients have a phone consultation
with Dr. Yeh. An appointment with the local referring physician is made within 1 month after
surgery. We request that follow up test results be performed by the referring physician at
1 month, 3 months, and 6 months after surgery, and faxed to our office. For thyroid cancer
patients, annual evaluation by the referring physician and phone consultation is required.
Please contact our office if you would like to participate
in this program >>
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References
1. Perrier ND, Ituarte PH, Morita E, et al. Parathyroid surgery: separating
promise from reality. J Clin Endocrinol Metab. 2002;87(3):1024-9.
2. Yeh M, Barraclough BM, Sidhu SB, Sywak MS, Delbridge LW. 200 Consecutive
parathyroid ultrasound studies by a single ultrasonologist. Endocrine Practice:in
press.
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